Registered Nurse, Case Manager

CVS Health

Telephonic Case Manager assisting patients and care teams at CVS Health. Requires extensive RN experience and strong clinical judgment in telephonic case management.

Posted 5/5/2026full-timeRemote • Louisiana, Mississippi, Montana, North Carolina, Texas • 🇺🇸 United StatesMid-LevelSenior💰 $54,095 - $155,538 per yearWebsite

About the role

Key responsibilities & impact

work intensely as a telephonic case manager with patients and their care team for fully and/or self-insured clients
application and/or interpretation of applicable criteria and clinical guidelines, standardized care management plans, polices, procedures and regulatory standards
assessing benefits and/or member’s needs to ensure appropriate administration of benefits
consult with supervisor and others in overcoming barriers in meeting goals and objectives
present cases at case conferences for multidisciplinary focus to benefit overall claim management
consult with clinical colleagues, supervisors, Medical Directors and/or other programs to overcome barriers
utilize motivational interviewing skills to ensure maximum member engagement

Requirements

What you’ll need

5+ years’ experience as a Registered Nurse with at least 1 year of experience in a hospital setting
A RN who resides in a compact state is required to have an active multistate license through the Nurse Licensure Compact (NLC)
Nurses residing in non‑compact states must hold an individual, state‑specific RN license for each state they support
1+ years’ experience documenting electronically using a keyboard
1+ years’ current or previous experience in Oncology, Transplant, Specialty Pharmacy, Pediatrics, Medical/Surgical, Behavioral Health/Substance Abuse or Maternity/ Obstetrics experience

Benefits

Comp & perks

medical, dental, and vision coverage
paid time off
retirement savings options
wellness programs
other resources, based on eligibility

ATS Keywords

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Applicant Tracking System Keywords

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Hard Skills & Tools

Registered Nursemotivational interviewingclinical guidelines interpretationbenefits assessmentcase managementelectronic documentationOncology experienceTransplant experiencePediatrics experienceBehavioral Health experience

Soft Skills

communicationconsultationproblem-solvingteam collaborationmember engagement

Certifications

active multistate RN licensestate-specific RN license